Take step 2 early or late with 227

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ulalalalaboy

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Hey guys and girls
I will apply to IM, and maybe GI later. I got a 227 on step one, average student rank-wise. I don't plan to go to Harvard or Southwestern, probably middle tear university based programs. Should I take step 2 late or early? My school is in Texas.
 
Hey guys and girls
I will apply to IM, and maybe GI later. I got a 227 on step one, average student rank-wise. I don't plan to go to Harvard or Southwestern, probably middle tear university based programs. Should I take step 2 late or early? My school is in Texas.

I think you need to go early. You should improve your score, most people do anyway and most people that want to do, do so.
 
I think you can do it either way. You have to gauge how well you can realistically score on Step 2. If you did very well on your shelf exams, then I think chances are you'll do well on Step 2, so you should take it early. But if you struggle on the shelves, then you might want to take it later. I actually recommend that you take it in September and do not choose the automatic release on ERAS. You review your score. If you like it, go ahead and release.
 
What is the "cut-off" for waiting to take step 2? 240?
 
What is the "cut-off" for waiting to take step 2? 240?

There obviously isn't one. But for IM, assuming an average or better CV (average HP in clinicals, maybe some research or a good EC or two) I'd say something in the 230-240 range exempts you from Step 2 unless your school or a program you want to go to requires it.

The thing is...you never know how or why programs are going to filter your app, and there's nothing you can do about it. Step 1 is generally used as a filter, not as a way to truly judge applicants. So as long as you get past the filter (whatever it is...which you'll never know) it doesn't really matter what the score is. And programs can filter 16 ways from Sunday...if there's a place to enter it in ERAS, they can filter on it. So somebody who scores 260 on both steps but only gets a P on their IM clerkship (probably because they're a a sociopathic douchebag who can't interact with other human beings) isn't going to get the same interview offers as the person who scores a respectable 230 on both steps but has honors in all of their clerkships.

So, as an example, let's say you get a 210 (or lower) on Step 1. Conventional wisdom is that you should take Step 2 early (I don't disagree with this for the most part). Which you do, and score a 245...hooray you! So you apply to 2 programs, A and B. Both use a Step filter. Program A filters on "Step 1 >220" while Program B filters on "Step 1 OR Step 2 >220."

Pop Quiz 1: Which program is going to invite you for an interview?

Answer: Program B

Now let's add another layer of complexity to the above question. Program A doesn't care what you got on your IM clerkship or SubI but Program B ALSO filters on "Honors on IM Clerkship." So you and your Step 1 210/Step2 245 and HP on your IM clerkship and SubI apply to both programs.

Pop Quiz 2: Which program is going to invite you for an interview?

Answer: Neither

Pop Quiz 3...How will you know why you were rejected from these programs (which may also use any number of other filters prior to even reviewing your app)?

Answer: You won't...so stop worrying about it.
 
gutonc I think pretty much covered it, but I will add that taking it early and getting it out of the way is good for your sanity as the year goes on. Are you really going to want to take it during or after interviews (when you haven't been thinking about medicine for a while)? Do it while 3rd year clerkships are more fresh and you will likely get a higher score. Not many people go down (unless you really don't study), and most people go up. One of my classmates with a score similar to yours shot up into the 250s on Step 2. That definitely will look good, although admittedly it may not matter much. If you want to go somewhere where you think you need a higher score, go ahead and take it and do what it takes to get that score. You could always point that out during an interview to demonstrate that your fundamentals of clinical knowledge are strong.
 
Thanks for your responses everyone.

I'm in a bit of a dilemma and didn't want to start a new thread. I haven't taken an EM rotation yet and have only spent time down there for new admits and stroke team. So in July, I am taking an AI/Sub-I in EM to see if I truly like it. If not, I am going the IM route for sure. As of right now, I have pretty strong letters (at least thats what I am told) from the Chairman, Vice-Chairman, Assistant PD of IM at my home program and my Research mentor.

Like I mentioned before, in July I am taking EM. Then in August I am schedule for an EKG elective (figure it would be good for EM or IM) and it is a tough elective to get so I do not want to drop it. As of right now, I am scheduled for GI in September. All of this is at my home program. Should I drop GI and pursue an AI in medicine? Or can I wait to take it a little later in the year? I feel as though I am a reasonably strong candidate for IM, and I reaaaally hope to end up at Uchicago or Northwestern.

Any advice would be much appreciated!
 
Thanks for your responses everyone.

I'm in a bit of a dilemma and didn't want to start a new thread. I haven't taken an EM rotation yet and have only spent time down there for new admits and stroke team. So in July, I am taking an AI/Sub-I in EM to see if I truly like it. If not, I am going the IM route for sure. As of right now, I have pretty strong letters (at least thats what I am told) from the Chairman, Vice-Chairman, Assistant PD of IM at my home program and my Research mentor.

Like I mentioned before, in July I am taking EM. Then in August I am schedule for an EKG elective (figure it would be good for EM or IM) and it is a tough elective to get so I do not want to drop it. As of right now, I am scheduled for GI in September. All of this is at my home program. Should I drop GI and pursue an AI in medicine? Or can I wait to take it a little later in the year? I feel as though I am a reasonably strong candidate for IM, and I reaaaally hope to end up at Uchicago or Northwestern.

Any advice would be much appreciated!

Bump, anyone🙂 Thanks🙂
 
Bump, anyone🙂 Thanks🙂

You need to have your IM SubI (and a LOR from it) in the bag before you start interviewing for IM. Drop the GI rotation and do your subI then.

If you do your EM rotation and love it, the conventional wisdom is that you need to do at least 1 EM away in order to get the required number of SLORs so you should probably just go ahead and set that up for October now since it will be hard to schedule one late. If you wind up hating EM, drop that away and do something else.
 
Hey guys and girls
I will apply to IM, and maybe GI later. I got a 227 on step one, average student rank-wise. I don't plan to go to Harvard or Southwestern, probably middle tear university based programs. Should I take step 2 late or early? My school is in Texas.

I would love to know how this turned out for you since I'm basically your Step 1 score twin and have the same exact question at the moment.
 
I would love to know how this turned out for you since I'm basically your Step 1 score twin and have the same exact question at the moment.

227'er here. You'll get tons of mid/upper mid tier interviews with this score. Unfortunately with the national average increasing every year you won't even get a sniff from a top 25 program. Not taking step 2 early worked well for me because I had a specific region in the US i was looking to match in and most of the programs were within my reach. If you think you will get interviews from NW, Uchic, OHSU, Emory, Virginia, Vandy, UChic, or better, you're wrong. You'll need to take step 2 early and rock it for that to happen.
 
I would love to know how this turned out for you since I'm basically your Step 1 score twin and have the same exact question at the moment.

Hey guys and girls
I will apply to IM, and maybe GI later. I got a 227 on step one, average student rank-wise. I don't plan to go to Harvard or Southwestern, probably middle tear university based programs. Should I take step 2 late or early? My school is in Texas.

223 step 1 here, and i took step 2 early and scored a 252 step 2.
it definitely helped my cause 👍
 
^^^ This.

A jump from ~225 to ~250 goes a long way; including how you think of yourself.
 
227'er here. You'll get tons of mid/upper mid tier interviews with this score. Unfortunately with the national average increasing every year you won't even get a sniff from a top 25 program. Not taking step 2 early worked well for me because I had a specific region in the US i was looking to match in and most of the programs were within my reach. If you think you will get interviews from NW, Uchic, OHSU, Emory, Virginia, Vandy, UChic, or better, you're wrong. You'll need to take step 2 early and rock it for that to happen.

"best" interviews I received with my jump were @ UW, Michigan, Baylor, Cornell, UCLA.
Snubbed by top Boston and Chicago programs
 
"best" interviews I received with my jump were @ UW, Michigan, Baylor, Cornell, UCLA.
Snubbed by top Boston and Chicago programs

i appreciate your input and you increase my incentive for taking it early.
 
For this coming cycle what date would be intermediate enough to not have a mandatory inclusion but also not be so late that it won't be able to improve chances of interview?
 
"best" interviews I received with my jump were @ UW, Michigan, Baylor, Cornell, UCLA.
Snubbed by top Boston and Chicago programs

Definitely agree with all of the above for the OP - most people without too much studying can get a significant boost in score on Step 2, which as golakers experience shows may help get some really great interviews - really no reason not to try it!

And OP, not sure how they came up, but hope you aren't set on those Chicago programs, have to be among the toughest non super elite program interviews to come by IMO
 
I will gladly add my anecdotal experience to the pile. I too had a 227 Step 1. I was pissed because I was scoring WAY better on my practice tests and I totally flubbed the real deal, so I studied my ass off for Step 2, took it in July, made it my b*tch, and got interviews at pretty much all my desired schools... those really desirable chicago schools shut me down though, but I did end up going to lots of really great programs.

As a side note, I did my Sub-I the month after Step 2 and I looked way smarter than I really was because I had just spent 8+ hours a day doing USMLE world questions and I subsequently rocked my Sub-I.

Ideal schedule: July--study, take Step 2 at the end(ish) of the month. August--Sub-I. September--????
October--get hella interviews cause you rocked Step 2.

TL;DR rock step 2 EARLY and it will open a lot of doors. Schedule your Sub-I for the month after Step 2 for a double-dose of awesome.
 
What would you guys recommend as the amount of time off needed to help with this step2 score boost to 250s?

Time off? You're kidding right?

I used plane ride time during interview season to study using a borrowed copy of the Kaplan books. I did USMLEasy (because I'm cheap and the school provided it for free) twice in a couple of evenings. I bumped 20 points.
 
What would you guys recommend as the amount of time off needed to help with this step2 score boost to 250s?

One month of dedicated studying is more than sufficient. My advice is get USMLE for Step 2, do all the questions as many times as you possibly can in that time. (2 times through is pretty doable if you're dedicated.) Step Up to Step 2 is good for superficial review, but I found questions to be the most beneficial use of my time.
 
again, thanks for the replies everyone.


hematopoiesis- i have essentially mapped out my schedule as you have already stated.
late july step 2
aug sub i
sept elective in medicine
oct mandatory school clerkship
nov away elective in medicine
 
again, thanks for the replies everyone.


hematopoiesis- i have essentially mapped out my schedule as you have already stated.
late july step 2
aug sub i
sept elective in medicine
oct mandatory school clerkship
nov away elective in medicine

This looks good to me. One thing to consider would be taking a month off in december or january to fit in all the awesome interviews you're gonna get with that >255 Step 2.
 
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What would you guys recommend as the amount of time off needed to help with this step2 score boost to 250s?

Time off? You're kidding right?

I used plane ride time during interview season to study using a borrowed copy of the Kaplan books. I did USMLEasy (because I'm cheap and the school provided it for free) twice in a couple of evenings. I bumped 20 points.

When I took it, I had a 2 week gap to "study" and honestly most of the time I just sat around and watched TV. If you have IM late in the year, a week or two is all you need... or a plane ride if you are a stud.

In terms of the earlier question re: what score is good enough to wait to take step 2. I say just get it out of the way. Use a bit of time to study early in the year and do some questions and you should be good to go. I know very few people that went down appreciably. Almost everyone I know went up.



again, thanks for the replies everyone.


hematopoiesis- i have essentially mapped out my schedule as you have already stated.
late july step 2
aug sub i
sept elective in medicine
oct mandatory school clerkship
nov away elective in medicine

The away in Nov may be a hard sell. It is right in the peak of interview season so you probably are going to miss a bunch of days. If you have to do an away, either schedule it in Sept or do it at a place where you don't really want to go so you don't piss people off by missing a bunch of days.
 
There obviously isn't one. But for IM, assuming an average or better CV (average HP in clinicals, maybe some research or a good EC or two) I'd say something in the 230-240 range exempts you from Step 2 unless your school or a program you want to go to requires it.

The thing is...you never know how or why programs are going to filter your app, and there's nothing you can do about it. Step 1 is generally used as a filter, not as a way to truly judge applicants. So as long as you get past the filter (whatever it is...which you'll never know) it doesn't really matter what the score is. And programs can filter 16 ways from Sunday...if there's a place to enter it in ERAS, they can filter on it. So somebody who scores 260 on both steps but only gets a P on their IM clerkship (probably because they're a a sociopathic douchebag who can't interact with other human beings) isn't going to get the same interview offers as the person who scores a respectable 230 on both steps but has honors in all of their clerkships.

So, as an example, let's say you get a 210 (or lower) on Step 1. Conventional wisdom is that you should take Step 2 early (I don't disagree with this for the most part). Which you do, and score a 245...hooray you! So you apply to 2 programs, A and B. Both use a Step filter. Program A filters on "Step 1 >220" while Program B filters on "Step 1 OR Step 2 >220."

Pop Quiz 1: Which program is going to invite you for an interview?

Answer: Program B

Now let's add another layer of complexity to the above question. Program A doesn't care what you got on your IM clerkship or SubI but Program B ALSO filters on "Honors on IM Clerkship." So you and your Step 1 210/Step2 245 and HP on your IM clerkship and SubI apply to both programs.

Pop Quiz 2: Which program is going to invite you for an interview?

Answer: Neither

Pop Quiz 3...How will you know why you were rejected from these programs (which may also use any number of other filters prior to even reviewing your app)?

Answer: You won't...so stop worrying about it.


Very good point. I think this happened to me as well - 219 on step 1 but a 238 on step 2. got rejected by programs where my step 2 was competitive and they accepted students from my school or something similar. they probably used a step 1 filter only at >220.

I think the step 2 is more important if you're an IMG though. so if you're the OP and a Tx med student, you shouldn't need to take it early unless you feel ready. getting a worse step 2 score is more detrimental if you're only taking it just to take it early than to wait and make sure you're ready.
 
I have a question: what is the 'latest' date we can take step 2 and still have it taken into consideration for interview invites? I noticed that taking it in July is considered early, but I have my sub I during that time so it wont be an option. Is late august/early september too late?
 
I have a question: what is the 'latest' date we can take step 2 and still have it taken into consideration for interview invites? I noticed that taking it in July is considered early, but I have my sub I during that time so it wont be an option. Is late august/early september too late?

There is no solid date for this. But the rough cut off given to us by our school is 8/1 for the score to be used in the screening process.
 
It doesn't matter whether you take it early or late. As long as your grades don't totally suck balls and you are from an American MD program, being that you are just aiming for a mid tier program, you should be just fine.
 
It doesn't matter whether you take it early or late. As long as your grades don't totally suck balls and you are from an American MD program, being that you are just aiming for a mid tier program, you should be just fine.

well I'm actually aiming for top tier programs. I have a low 230s score and want to do really well on step 2 to give me a better shot.
 
well I'm actually aiming for top tier programs. I have a low 230s score and want to do really well on step 2 to give me a better shot.

LoudBark is wrong. The step 2 score can only help you, IF you've made it past the step 1 screen of many top programs.

PD know that step 2 is the better predictor of residency success. Step 1 is actually garbage for predicting residency success, but it's the one standardized score available to help sort out applications early on, so it is what it is . . . you tend to assume that most people score better on step 2, because most people do.
 
Hey guys and girls
I don't plan to go to Harvard or Southwestern, probably middle tear university based programs.

Actually I am not wrong if he is ONLY looking to go to as stated ABOVE a "middle tier U. program".

I guess it depends on what you define as a middle tier U. program then.

For instance, most would think places like UT Houston, U of Florida, U of Wisconsin, U of Minnesota, Rush, Loyola, U of Colorado.....etc, etc.........to be examples of "middle tier U programs".

With his stats as an American MD grad, he should do fine with or without step 2 at such "middle tier U programs".

I do agree step 2 is needed for the more competitive programs.......but maybe you just have a different definition of what a "middle tier" program is than the above examples? Maybe it would be more helpful if the OP listed specific programs as I am sure everyone has a different definition of what "middle tier" is.
 
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Step 2 will still help with the match. Eveything else bring equal a candidate with a good step 2 will be in a better position every single time. There is simply no reason not to take step 2 from a strategy standpoint outside of an astronomical step 1 to begin with.

Actually I am not wrong if he is ONLY looking to go to as stated ABOVE a "middle tier U. program".

I guess it depends on what you define as a middle tier U. program then.

For instance, most would think places like UT Houston, U of Florida, U of Wisconsin, U of Minnesota, Rush, Loyola, U of Colorado.....etc, etc.........to be examples of "middle tier U programs".

With his stats as an American MD grad, he should do fine with or without step 2 at such "middle tier U programs".

I do agree step 2 is needed for the more competitive programs.......but maybe you just have a different definition of what a "middle tier" program is than the above examples? Maybe it would be more helpful if the OP listed specific programs as I am sure everyone has a different definition of what "middle tier" is.
 
There is simply no reason not to take step 2 from a strategy standpoint outside of an astronomical step 1 to begin with.

The reason not to take step 2 is that with a 227 it is likely solid enough to match at a middle tier program (depending of course of what your definition and the OP definition of exactly what programs are "middle tier".) He/she could actually go down on step 2. Weirder things have happened. Most people study their behinds off for step 1 and take step 2 lighter and if he went down 10 points in step 2, he is not doing himself any favors.

I do wholeheartedly agree that going UP on step 2 can only help him.......but does he really need an "astronomical step 1" to land a spot at a "middle tier" program?

If he was shooting for "top tier", then of course take step 2 early.....but with most "middle tiers", it likely isn't the risk of a lower step 2 and he should be able to match at a mid tier IM program with 1. being an American MD grad 2. step 1 227 3. decent recs 4. decent but not necessarily earth shattering grades.
 
The reason not to take step 2 is that with a 227 it is likely solid enough to match at a middle tier program (depending of course of what your definition and the OP definition of exactly what programs are "middle tier".) He/she could actually go down on step 2. Weirder things have happened. Most people study their behinds off for step 1 and take step 2 lighter and if he went down 10 points in step 2, he is not doing himself any favors.

I do wholeheartedly agree that going UP on step 2 can only help him.......but does he really need an "astronomical step 1" to land a spot at a "middle tier" program?

If he was shooting for "top tier", then of course take step 2 early.....but with most "middle tiers", it likely isn't the risk of a lower step 2 and he should be able to match at a mid tier IM program with 1. being an American MD grad 2. step 1 227 3. decent recs 4. decent but not necessarily earth shattering grades.

You would make the case that step 2 isn't necessary for a match in general, especially for mid tier program, somewhere, anywhere. I would agree with this statement.

However, for any candidate to maximize their application and chance to match exactly where they want one should take the step 2 early so it's a factor. IM is becoming more competitive if the last two years application cycles give us any indicators of this kind of thing, and I think they do, and I think it is going to start being more difficult to nail down that number one program on your list even in a long list of solid mid tier university programs.

The step 1, the american MD, and the pulse will get your foot in the door at many places (application onto a PD's desk), but I don't feel right about giving advice here unless I'm doing my best to help people MAXIMIZE their efforts. Even as much as 3-4 years ago, I would have told most people to skip step 2 early. I just don't think that is the best advice any longer.
 
You would make the case that step 2 isn't necessary for a match in general, especially for mid tier program, somewhere, anywhere. I would agree with this statement.

However, for any candidate to maximize their application and chance to match exactly where they want one should take the step 2 early so it's a factor. IM is becoming more competitive if the last two years application cycles give us any indicators of this kind of thing, and I think they do, and I think it is going to start being more difficult to nail down that number one program on your list even in a long list of solid mid tier university programs.

The step 1, the american MD, and the pulse will get your foot in the door at many places (application onto a PD's desk), but I don't feel right about giving advice here unless I'm doing my best to help people MAXIMIZE their efforts. Even as much as 3-4 years ago, I would have told most people to skip step 2 early. I just don't think that is the best advice any longer.

I did really well on step 1 (>265) so step 2 can only stay the same or go down. I go to a low-tier med school and am looking at top IM residency so I was just wondering when I should take step 2. I just think I should take it in late September that way I can see my score and then decide to release it or not. This way if I do well again it will still be available to schools for my interviews/rank. More harm than good can come from me taking it, but you seem to be advocating to take it early no matter what? Advice?
 
I did really well on step 1 (>265) so step 2 can only stay the same or go down. I go to a low-tier med school and am looking at top IM residency so I was just wondering when I should take step 2. I just think I should take it in late September that way I can see my score and then decide to release it or not. This way if I do well again it will still be available to schools for my interviews/rank. More harm than good can come from me taking it, but you seem to be advocating to take it early no matter what? Advice?

I think I mentioned earlier that if you have an excellent step one going in then you can wait on it.
 
Well yeah, but why bother reading the whole thread (all 1 page of it) when you can just post a nearly identical question and get somebody to answer it?

Cool story Bro
 
You need to have your IM SubI (and a LOR from it) in the bag before you start interviewing for IM. Drop the GI rotation and do your subI then.

Sorry to hijack the thread...came across this and kind of ran into some issues...

Couple problems with my app, I'd really like some feedback on:
1. I'm not going to *start* my sub-I until mid-September - my sub-I is pass-fail regardless. Is this a huge problem? Will programs very nicely ignore the whole sub-I thing (please)? I already have my LORs. I don't know what they would hope to find out from my sub-I other than that I'm not a total ass and I can pass a P/F rotation.

2. My 3rd year IM clerkship was not graded on a H/HP/P/MP/F - the grading scale is such that looking at my score, you'd really have no absolute idea where I fall (you can suspect it wasn't great, which, let's face it, it wasn't). While not a good thing, does being somewhere in the 3rd quartile for the clerkship really hurt my app? Obviously it doesn't help, but does it *completely* cut me out of applying to places such as Baylor, Emory, Chicago, Vanderbilt, Cornell, Duke (you can assess the institutions individually if you want). Obviously I am free to waste my money on applying to MGH, UCSF and Hopkins as I please ;-)

Otherwise, I have about average grades and a 240+ step 1 (hopefully a high step 2 ck, and I just took cs). Research (NIH), 1 pub, master's degree, from mid-tier US med school (w/ nice scholarship). As far as I can tell, I don't have any other huge problems with my application - I have not killed any patients yet/my personality is not completely toxic afaik.
 
To have your step 2 carry more weight in your application when is the latest you should take it by? Mid Sept? Late September?

Thanks... I m in the same position; Step 1 220 but I ve been busting my ass studying for the Step 2 now so I really want it to count in my application.
 
To have your step 2 carry more weight in your application when is the latest you should take it by? Mid Sept? Late September?

Thanks... I m in the same position; Step 1 220 but I ve been busting my ass studying for the Step 2 now so I really want it to count in my application.

You're SGU, right? All the SGU kids I knew back in the day took it in July.

You need to take it ASAP so you can get your score in. A 220 on Step 1 for an IMG is nothing to write home about. It doesn't put you out of the running for a spot, but it does you no favors. And most PDs want to see scores for both steps for IMGs to avoid the possibility of you not being ECFMG certified by the time July 1 rolls around.

TL;DR...take it tomorrow.
 
You're SGU, right? All the SGU kids I knew back in the day took it in July.

You need to take it ASAP so you can get your score in. A 220 on Step 1 for an IMG is nothing to write home about. It doesn't put you out of the running for a spot, but it does you no favors. And most PDs want to see scores for both steps for IMGs to avoid the possibility of you not being ECFMG certified by the time July 1 rolls around.

TL;DR...take it tomorrow.

Most people I know took it Mid September... some took it late August? I agree that a 220 isnt great for an img thats why I ve corrected my mistakes from step 1 studying and have been working hard for step 2..
 
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There is no solid date for this. But the rough cut off given to us by our school is 8/1 for the score to be used in the screening process.

How does your school use step 2 by August 1 (8/1) if the match doesnt even open untill Sept 15? Just wondering because I am curious about the same question?
 
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How does your school use step 2 by August 1 (8/1) if the match doesnt even open untill Sept 15? Just wondering because I am curious about the same question?

this allows for scores to come back in time before ERAS is submitted. it's a conservative deadline since the NBME will release scores in whatever time frame they feel like (usually 3-6 weeks)
 
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